Provider Demographics
NPI:1740529890
Name:DURHAM, SHARON OLETA (MDIV)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:OLETA
Last Name:DURHAM
Suffix:
Gender:F
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 E CEDAR ROCK ST
Mailing Address - Street 2:
Mailing Address - City:PICKENS
Mailing Address - State:SC
Mailing Address - Zip Code:29671-2349
Mailing Address - Country:US
Mailing Address - Phone:864-723-4446
Mailing Address - Fax:
Practice Address - Street 1:523 E CEDAR ROCK ST
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2349
Practice Address - Country:US
Practice Address - Phone:864-723-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-10
Last Update Date:2013-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral